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Overall and Disease...
Overall and Disease-Specific Mortality in Patients With Cushing Disease: A Swedish Nationwide Study
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- Ragnarsson, Oskar, 1971 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
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- Olsson, Daniel S, 1983 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
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- Papakokkinou, Eleni (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
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- Chantzichristos, Dimitrios, 1976 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
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- Dahlqvist, Per (author)
- Umeå universitet,Avdelningen för medicin,Umea Univ, Dept Publ Hlth & Clin Med, SE-90187 Umea, Sweden
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- Segerstedt, Elin (author)
- Umeå universitet,Avdelningen för medicin,Umea Univ, Dept Publ Hlth & Clin Med, SE-90187 Umea, Sweden
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- Olsson, Tommy (author)
- Umeå universitet,Avdelningen för medicin,Umea Univ, Dept Publ Hlth & Clin Med, SE-90187 Umea, Sweden
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- Petersson, Maria (author)
- Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
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- Berinder, Katarina (author)
- Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
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- Bensing, Sophie (author)
- Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
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- Hoybye, Charlotte (author)
- Karolinska Institutet,Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden
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- Edén Engström, Britt (author)
- Uppsala universitet,Endokrinologi och mineralmetabolism,Uppsala Univ Hosp, Sweden
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- Burman, Pia (author)
- Lund Univ, Skane Univ Hosp, Dept Endocrinol, SE-21428 Malmo, Sweden,Department of Endocrinology, Skåne University Hospital, University of Lund, Malmö, Sweden
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- Bonelli, Lorenza (author)
- Lund Univ, Skane Univ Hosp, Dept Endocrinol, SE-21428 Malmo, Sweden,Department of Endocrinology, Skåne University Hospital, University of Lund, Malmö, Sweden
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- Follin, Cecilia (author)
- Skane Univ Hosp, Dept Endocrinol, SE-22242 Lund, Sweden,Department of Endocrinology, Skåne University Hospital, Lund, Sweden
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- Petranek, David (author)
- Skane Univ Hosp, Dept Endocrinol, SE-22242 Lund, Sweden,Department of Endocrinology, Skåne University Hospital, Lund, Sweden
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- Erfurth, Eva Marie (author)
- Skane Univ Hosp, Dept Endocrinol, SE-22242 Lund, Sweden,Department of Endocrinology, Skåne University Hospital, Lund, Sweden
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- Wahlberg, Jeanette (author)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Endokrinmedicinska kliniken,Department of Endocrinology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden,Linkoping Univ, Dept Endocrinol, SE-58183 Linkoping, Sweden;Linkoping Univ, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden
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- Ekman, Bertil (author)
- Linköpings universitet,Avdelningen för kardiovaskulär medicin,Medicinska fakulteten,Region Östergötland, Endokrinmedicinska kliniken,Department of Endocrinology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden,Linkoping Univ, Dept Endocrinol, SE-58183 Linkoping, Sweden;Linkoping Univ, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden
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- Akerman, Anna-Karin (author)
- Karolinska Institutet,Orebro Univ, Sweden
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- Schwarcz, Erik (author)
- Orebro Univ, Sch Hlth & Med Sci, Dept Internal Med, SE-70281 Orebro, Sweden,Department of Internal Medicine, School of Health and Medical Sciences, Örebro University, Örebro, Sweden
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- Bryngelsson, Ing-Liss (author)
- Orebro Univ Hosp, Dept Occupat & Environm Med, SE-70281 Orebro, Sweden,Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden
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- Johannsson, Gudmundur, 1960 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
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(creator_code:org_t)
- 2019-02-01
- 2019
- English.
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In: Journal of Clinical Endocrinology and Metabolism. - : ENDOCRINE SOC. - 0021-972X .- 1945-7197. ; 104:6, s. 2375-2384
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https://doi.org/10.1...
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Abstract
Subject headings
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- Context: Whether patients with Cushing disease (CD) in remission have increased mortality is still debatable. Objective: To study overall and disease-specific mortality and predictive factors in an unselected nationwide cohort of patients with CD. Design, Patients, and Methods: A retrospective study of patients diagnosed with CD, identified in the Swedish National Patient Registry between 1987 and 2013. Medical records were systematically reviewed to verify the diagnosis. Standardized mortality ratios (SMRs) with 95% CIs were calculated and Cox regression models were used to identify predictors of mortality. Results: Of 502 identified patients with CD (n = 387 women; 77%), 419 (83%) were confirmed to be in remission. Mean age at diagnosis was 43 (SD, 16) years and median follow-up was 13 (interquartile range, 6 to 23) years. The observed number of deaths was 133 vs 54 expected, resulting in an overall SMR of 2.5 (95% CI, 2.1 to 2.9). The commonest cause of death was cardiovascular diseases (SMR, 3.3; 95% CI, 2.6 to 4.3). Excess mortality was also found associated with infections and suicide. For patients in remission, the SMR was 1.9 (95% CI, 1.5 to 2.3); bilateral adrenalectomy and glucocorticoid replacement therapy were independently associated with increased mortality, whereas GH replacement was associated with improved outcome. Conclusion: Findings from this large nationwide study indicate that patients with CD have excess mortality. The findings illustrate the importance of achieving remission and continued active surveillance, along with adequate hormone replacement and evaluation of cardiovascular risk and mental health.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Ragnarsson, Oska ...
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Olsson, Daniel S ...
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Papakokkinou, El ...
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Chantzichristos, ...
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Dahlqvist, Per
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Segerstedt, Elin
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show more...
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Olsson, Tommy
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Petersson, Maria
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Berinder, Katari ...
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Bensing, Sophie
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Hoybye, Charlott ...
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Edén Engström, B ...
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Burman, Pia
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Bonelli, Lorenza
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Follin, Cecilia
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Petranek, David
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Erfurth, Eva Mar ...
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Wahlberg, Jeanet ...
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Ekman, Bertil
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Akerman, Anna-Ka ...
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Schwarcz, Erik
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Bryngelsson, Ing ...
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Johannsson, Gudm ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Endocrinology an ...
- Articles in the publication
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Journal of Clini ...
- By the university
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Linköping University
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Örebro University
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Umeå University
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Uppsala University
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Karolinska Institutet
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University of Gothenburg